Maine health insurance cooperative leaves N.H. market, reeling from losses

  • Community Health Options logo Community Health Options—Courtesy

Monitor staff
Published: 9/2/2016 12:58:42 AM

There will be one fewer option for health insurance in New Hampshire next year, as Maine-based Community Health Options will withdraw due to financial losses, requiring 11,581 people to find a new carrier.

The company drew attention in 2014 when it was reported to be the only health insurance cooperative in the country to make money, then drew attention of a different kind in 2015 when, after expanding into New Hampshire, it reported a staggering $31 million loss and stopped taking new clients.

In the latest move, the firm said it is withdrawing from New Hampshire to focus on Maine, its core market. Last week it reported losing $3.3 million in the second quarter of the year, although that’s an improvement from an $8.4 million loss in the first quarter.

In New Hampshire, according to the state insurance department, 11,581 people have insurance coverage through Health Options, including group members. In Maine, it has 66,157 members.

“We think it is in the best long-term interest of consumers and the company itself for Health Options to focus on its core business in its home state as it works through financial issues,” New Hampshire Insurance Commissioner Roger Sevigny said in a statement.

Health Options has experienced “higher-than-expected costs in the form of claims from its enrollees,” according to the insurance department.

This is a common problem among health insurance companies as the Affordable Care Act matures. Fewer healthy people are signing up for the service than had been hoped, providing less income from premiums and more costs from claims.

The result has been insurance companies dropping out of the system – although New Hampshire, with four firms offering programs, is in comparatively good shape – and sharp increases in premiums. Health Options, for example, has sought a 25 percent increase in premiums for 2017 from the Maine Bureau of Insurance.

The New Hampshire Insurance Department said about 1,400 of Health Options’ customers in the state were enrolled under the Premium Assistance Program as part of the state’s Medicaid expansion.

Health Options customers will receive a letter from Health Options in the next few weeks notifying them directly that Health Options coverage will not be available in 2017. In order to ensure continued coverage, they must select a new plan during open enrollment for the state’s health insurance marketplace, which begins Nov. 1.

Consumers who enroll in a new plan by Dec. 31 will have no gap in coverage, the insurance department said, as the Health Options plans will remain in effect until new coverage begins on Jan. 1, 2017.

The insurance department “advises residents to select a new plan by Dec. 15 in order to ensure a smooth transition,” and noted that questions about Health Options coverage provided through work “should initially be directed to the employer.”

“My hope is that this plan to focus on its core market in Maine will help Health Options regain its footing and ultimately return to New Hampshire’s health insurance market,” Sevigny said.

To enroll or to change plans that program, customers should call the HHS Medicaid Service Center, at 888-901-4999.

(David Brooks can be reached at 369-3313, or on Twitter @GraniteGeek.)

David Brooks bio photo

David Brooks is a reporter and the writer of the sci/tech column Granite Geek and blog, as well as moderator of Science Cafe Concord events. After obtaining a bachelor’s degree in mathematics he became a newspaperman, working in Virginia and Tennessee before spending 28 years at the Nashua Telegraph . He joined the Monitor in 2015.

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